DoD expands lung cancer screening for vets

Nov. 12, 2013 - 04:06PM
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A third military hospital has begun offering lung cancer screenings for patients considered to be at high risk for developing the disease.

The Naval Medical Center San Diego has joined Walter Reed National Military Medical Center in Bethesda, Md., and Naval Medical Center Portsmouth, Va., in offering the screenings for smokers or former smokers over age 55 who averaged a pack of day for 30 years.

The broadening military lung cancer detection program puts the Defense Department at the forefront of lung cancer death prevention, said Laurie Fenton Ambrose, president of the Washington, D.C.-based Lung Cancer Alliance, adding that the civilian community is just starting to embrace the practice.

“It’s heartening. [The military] did not have to do this, but they knew it was the ethical thing to do. It shows that the leadership of the military health system is forward-thinking,” Ambrose said during a screening awareness event at Walter Reed on Nov. 6.

In late July, the U.S. Preventive Services Task Force issued a draft recommendation proposing that those considered at high risk for developing lung cancer be screened.

A 2011 DoD survey of active-duty troops showed that nearly one-fourth smoked, with Marines having the highest rate, nearly 32 percent, and Air Force troops the lowest, at 17 percent.

Aside from smoking, troops also may be at higher risk for lung cancer because of environmental contaminants encountered during military operations, from chemical fumes and carbon monoxide to air pollution from waste disposal plants and open-air burn pits.

Since Walter Reed began offering the scans in late 2012, it has screened more than 100 patients and identified and began treating three for cancer, according to the program coordinator, Navy Cmdr. Elena Prezesio.

The screenings also are offered at the Veterans Affairs Phoenix Health Care System and are scheduled to begin at eight other sites as part of a two-year pilot program: Ann Arbor, Mich.; Charleston, S.C.; Cincinnati; Durham, N.C.; Minneapolis; NY Harbor, N.Y.; Portland, Ore.; and San Francisco.

The slow rollout of the pilot, which was supposed to begin by the end of October but was not formally announced until Nov. 6, has disappointed some military advocacy groups.

Rick Weidman, policy and governmental affairs director for Vietnam Veterans of America, said lives hang in the balance as VA drags its heels.

“They’ve had the equipment, so why haven’t they been doing it? This is the result of poor leadership at the [Veterans Integrated Service Network] level,” Weidman said.

The prevalence of smoking among veterans is estimated to be up to 40 percent higher than among the general population.

Dr. Linda Kinsinger, with the Veterans Health Administration’s Office of Patient Care Services, said VA is excited to offer the screenings, which can lower the risk of dying from lung cancer by 20 percent.

But it is moving cautiously and following the National Cancer Institute’s National Lung Screening Trial.

“It’s important to remember that screening for lung cancer is a complex process and can produce false alarms that lead to additional procedures,” Kinsinger said.

“Screenings can be lifesavers, but they can also carry emotional consequences that can be a problem for some patients,” she said. “That’s one of the reasons we’re starting in only eight facilities. It’s important to evaluate what works well and what’s needed to meet the needs of veterans.”

The survival rate for early stage lung cancer is nearly 50 percent. The rate plummets to 1 percent for late stage disease.